From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

Ryan Suk, MS

From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

Elizabeth Y. Chiao, MD, MPH

From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

Jagpreet Chhatwal, PhD

From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

Peihua Qiu, PhD

From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

Timothy Wilkin, MD, MPH

From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

Alan G. Nyitray, PhD

From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

Andrew G. Sikora, MD, PhD

From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

Ashish A. Deshmukh, PhD, MPH

From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

From University of Florida, Gainesville, Florida; Baylor College of Medicine and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas; Harvard Medical School, Boston, Massachusetts; and Weill Cornell Medicine, New York, New York.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health (NIH).

Acknowledgment: The authors thank Michael D. Swartz, PhD, of The University of Texas School of Public Health at Houston for constructive comments that improved the quality of the manuscript.

Grant Support: By National Cancer Institute grant R01 CA163103.

Disclosures: Dr. Chiao reports grants from the NIH during the conduct of the study. Dr. Chhatwal reports grants and personal fees from Merck and Gilead Sciences outside the submitted work. Dr. Wilkin reports grants from Gilead Sciences and Bristol-Myers Squibb and grants and personal fees from GlaxoSmithKline/ViiV Healthcare outside the submitted work. Dr. Sikora reports grants from Advaxis outside the submitted work. Authors not named here have disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-1363.

Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer and Johnson & Johnson.

Abstract

Background:

The burden of human papillomavirus (HPV)–positive oropharyngeal squamous cell carcinoma (OPSCC) is disproportionately high among men, yet empirical evidence regarding the difference in prevalence of oral HPV infection between men and women is limited. Concordance of oral and genital HPV infection among men is unknown.

Objective:

To determine the prevalence of oral HPV infection, as well as the concordance of oral and genital HPV infection, among U.S. men and women.

The overall prevalence of oral HPV infection was 11.5% (95% CI, 9.8% to 13.1%) in men and 3.2% (CI, 2.7% to 3.8%) in women (equating to 11 million men and 3.2 million women nationwide). High-risk oral HPV infection was more prevalent among men (7.3% [CI, 6.0% to 8.6%]) than women (1.4% [CI, 1.0% to 1.8%]). Oral HPV 16 was 6 times more common in men (1.8% [CI, 1.3% to 2.2%]) than women (0.3% [CI, 0.1% to 0.5%]) (1.7 million men vs. 0.27 million women). Among men and women who reported having same-sex partners, the prevalence of high-risk HPV infection was 12.7% (CI, 7.0% to 18.4%) and 3.6% (CI, 1.4% to 5.9%), respectively. Among men who reported having 2 or more same-sex oral sex partners, the prevalence of high-risk HPV infection was 22.2% (CI, 9.6% to 34.8%). Oral HPV prevalence among men with concurrent genital HPV infection was 4-fold greater (19.3%) than among those without it (4.4%). Men had 5.4% (CI, 5.1% to 5.8%) greater predicted probability of high-risk oral HPV infection than women. The predicted probability of high-risk oral HPV infection was greatest among black participants, those who smoked more than 20 cigarettes daily, current marijuana users, and those who reported 16 or more lifetime vaginal or oral sex partners.

Limitation:

Sexual behaviors were self-reported.

Conclusion:

Oral HPV infection is common among U.S. men. This study's findings provide several policy implications to guide future OPSCC prevention efforts to combat this disease.